Journal of Back and Musculoskeletal Rehabilitation最新文献

{"title":"Effects of home-based exercise on disease activity, spinal mobility, functionality and systemic inflammatory indices in ankylosing spondylitis: A randomized controlled trial.","authors":"Merve İrem Uçar, Sibel Çağlar, Işıl Üstün","doi":"10.1177/10538127261492503","DOIUrl":"https://doi.org/10.1177/10538127261492503","url":null,"abstract":"<p><p>BackgroundExercise is a component of ankylosing spondylitis (AS) management, with home-based programs widely used due to their feasibility. However, their clinical effects and impact on novel inflammatory biomarkers such as SII and SIRI remain unclear.ObjectıveThis study evaluated the effects of a 6-week home-based exercise program on disease activity, spinal mobility, functional status, systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI) in patients with AS, with a 4-week post-intervention follow-up.MethodsPatients with AS were randomly assigned to a control group (n = 23) receiving pharmacological treatment alone or a home exercise group (n = 27) receiving pharmacological treatment plus a 6-week home-based exercise program. The home exercise group performed a program including spinal range of motion (ROM), stretching, and breathing exercises based on ASAS/EULAR recommendations, 5 days/week, 1 set of 10 repetitions, for approximately 40 min per day. Outcomes included the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Ankylosing Spondylitis Disease Activity Score C-reactive protein (ASDAS-CRP) and erythrocyte sedimentation rate (ASDAS-ESR), SII and SIRI. Assessments were performed at baseline (T0), after treatment (T1) and 4 weeks after T1 (T2).ResultsThe home exercise group showed a trend toward within-group improvement in BASMI at T1 (p = 0.047), not significant after Bonferroni correction, and significant improvement at T2 (p < 0.001); however, no significant Group × Time interaction or between-group difference was observed. No significant within-group changes were observed in BASDAI, BASFI, ASDAS, SII, or SIRI. In controls, BASDAI decreased at T1 and T2 (p = 0.136 and 0.060), but not after Bonferroni correction. No significant between-group differences were observed.ConclusıonA 6-week home exercise program was associated with a within-group improvement in spinal mobility at 4-week follow-up, while the control group showed a within-group reduction in BASDAI that did not remain significant after Bonferroni correction. BASFI, ASDAS, SII, and SIRI remained unchanged, and no significant between-group differences were observed in any outcome. Future studies should clarify whether structured home exercise can provide sustained and clinically meaningful improvements in spinal mobility and disease activity.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":" ","pages":"10538127261492503"},"PeriodicalIF":1.6,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of blood flow restriction therapy on functional outcomes in patients with distal radius fracture: A systematic review with meta-analysis.","authors":"Héctor Gutiérrez-Espinoza, Iván Cuyúl-Vásquez, Juan Valenzuela-Fuenzalida, Felipe Ponce-Fuentes, Javier Román-Veas, Felipe Araya-Quintanilla","doi":"10.1177/10538127261489858","DOIUrl":"https://doi.org/10.1177/10538127261489858","url":null,"abstract":"<p><p>BackgroundNo previous systematic reviews have evaluated the effects of blood flow restriction therapy (BFRT) in addition to other therapeutic interventions on clinical outcomes in patients with distal radius fractures (DRFs).ObjectiveTo determine the clinical effects of BFRT on functional outcomes in patients with DRFs.MethodsAn electronic search was performed using the MEDLINE, CENTRAL, EMBASE, Web of Science, PEDro, CINAHL, SPORTDiscus, and LILACS databases. The eligibility criteria included randomized clinical trials (RCTs) investigating the effects of BFRT with or without other therapeutic interventions on functional outcomes in patients with DRFs. Two authors independently performed the searches, study selection, data extraction, and risk of bias assessment using the Cochrane Risk of Bias 2.0. Data were pooled using a Hartung-Knapp-Sidik-Jonkman random-effects method or Mantel-Haenszel fixed-effects model. Certainty of evidence was assessed using GRADE.ResultsFour RCTs met the eligibility criteria. For the comparison of BFRT plus standard rehabilitation versus standard rehabilitation alone, at four weeks and six to eight weeks, the overall mean difference (MD) for PRWE was -5.41 points (<i>p</i> = 0.39), DASH was 1.94 points (<i>p</i> = 0.84), grip strength was -2.47% (<i>p</i> = 0.66), pinch strength was 0.28 kg (<i>p</i> = 0.59), wrist flexion-extension range of motion was 4.30 degrees (<i>p</i> = 0.33), and VAS was 0.43 cm (<i>p</i> = 0.09).ConclusionsGiven the limited available evidence, the effectiveness of adding BFRT to standard rehabilitation remains uncertain. Preliminary findings suggest that BFRT did not improve any of the functional outcomes. More clinical trials, in both quantity and quality, are needed to confirm the clinical effects of BFRT in patients with DRFs.<b>PROSPERO registration:</b> CRD42021260589.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":" ","pages":"10538127261489858"},"PeriodicalIF":1.6,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Turkish cultural adaptation and measurement properties of the Brief Assessment of Distress about Pain (BADP-TR).","authors":"Hasan Atacan Tonak, Fatoş Kırteke Duman, Sultan Baştürk, Ozan Demirci","doi":"10.1177/10538127261491783","DOIUrl":"https://doi.org/10.1177/10538127261491783","url":null,"abstract":"<p><p>BackgroundPain-related affective distress may influence rehabilitation participation and outcomes. The four-item Brief Assessment of Distress about Pain (BADP) provides a brief measure of this construct.ObjectiveTo translate and culturally adapt the BADP into Turkish (BADP-TR) and initially evaluate its measurement properties.MethodsTurkish-speaking adults recruited consecutively from outpatient physiotherapy and rehabilitation clinics in Türkiye completed baseline assessment (n = 104); 48 completed a 1-week retest. Structural validity, internal consistency, relative reliability, measurement error, and hypothesis-based construct validity were evaluated. Additional post hoc analyses compared current-pain (n = 59) and no-current-pain (n = 45) scores and repeated CFA/internal-consistency analyses in n = 104, n = 93 excluding pain-naive respondents, and n = 59 current-pain participants.ResultsA one-factor ordinal CFA fit the total sample well (CFI = 0.999; TLI = 0.995; RMSEA = 0.043; SRMR = 0.062), with high internal consistency (α = 0.844; ω = 0.875; ordinal α = 0.874). Sensitivity analyses yielded broadly similar estimates. ICC(A,1) and ICC(C,1) were 0.815 and 0.847; mean scores decreased and stability was not externally verified. Current-pain status did not clearly differentiate BADP-TR scores (mean difference = 0.73, 95% CI -0.70 to 2.16; Hedges' g = 0.19; p = 0.315). All four construct-validity correlation hypotheses were supported.ConclusionThe BADP-TR showed unidimensionality, high internal consistency, acceptable group-level relative reliability with limited individual-level precision, and construct-validity support, although the predicted correlation ordering was not reproduced. Individual-level use should remain cautious pending further validation.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":" ","pages":"10538127261491783"},"PeriodicalIF":1.6,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Oswestry Disability Index for low back pain: Translation into Persian and validation within a Persian-speaking population - an update.","authors":"Keyvan Mostofi, Kamran Shirbache, Ali Shirbacheh, Morad Peyravi","doi":"10.1177/10538127261488512","DOIUrl":"https://doi.org/10.1177/10538127261488512","url":null,"abstract":"<p><p>BackgroundThe Oswestry Disability Index (ODI) is widely used to assess disability due to low back pain. Existing Persian versions were developed in Iran only and do not reflect the full linguistic and cultural diversity of Persian speakers worldwide.ObjectiveThis study had two aims: (1) to provide an updated, culturally inclusive Persian translation and adaptation of the ODI following the Beaton cross-cultural adaptation guidelines, and (2) to evaluate, per the COSMIN taxonomy of measurement properties, its reliability and inter-method agreement across diverse Persian speakers. The translation was refined through a structured five-stage process and reviewed by native speakers from Iran, Afghanistan, Tajikistan, and diaspora communities.Methods578 participants with low back pain (aged 18-86) completed the Persian ODI twice in a single session, once alone (self-administered) and once with an interviewer, to assess inter-method agreement. Reliability and agreement were analyzed using paired t-test, Wilcoxon test, Cohen's d, ICC, and Bland-Altman limits of agreement.ResultsMean ODI scores were 13.83 ± 12.06 (Alone) and 14.55 ± 12.46 (With interviewer). ICC(2,1) was 0.95, indicating excellent reliability, while Cohen's d = 0.18 indicated a small, non-significant effect. Bland-Altman limits of agreement ranged from -6.91 to +8.35.ConclusionThe updated Persian ODI, developed and evaluated per established cross-cultural adaptation and measurement-property guidelines, shows excellent reliability and agreement across diverse Persian-speaking populations. Interviewer administration yielded slightly higher scores, but the difference was small and not clinically significant. This version can be confidently used for clinical and research purposes across Persian-speaking communities worldwide.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":" ","pages":"10538127261488512"},"PeriodicalIF":1.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet-Rich plasma for adhesive capsulitis: An umbrella review of effects on pain, function, and range of motion.","authors":"Fanny Johnsson Öman, Bengt Månsson, Jenny Viklund, Flávio Fidêncio De Lima, Maria Christidis, Giancarlo De La Torre Canales, Nikolaos Christidis","doi":"10.1177/10538127261489859","DOIUrl":"https://doi.org/10.1177/10538127261489859","url":null,"abstract":"<p><p>BackgroundAdhesive capsulitis is a common and disabling shoulder condition with substantial impact on pain and function, yet the role of platelet-rich plasma (PRP) injections remains uncertain.ObjectiveThis umbrella review aimed to synthesize the evidence on the effects of PRP on pain, shoulder range of motion, and function in adults with adhesive capsulitis.MethodsA search of MEDLINE, Embase, Cochrane Library, Web of Science, and CINAHL was conducted from inception to June 2025. Systematic reviews and meta-analyses were included and appraised using the Joanna Briggs Institute umbrella review methodology, and only reviews meeting predefined methodological quality criteria were included in the synthesis. The review was registered in PROSPERO (CRD420251024935).ResultsSix systematic reviews meeting the predefined critical methodological criteria were included. Across reviews, PRP was generally associated with greater improvements in pain, shoulder range of motion, and functional outcomes at intermediate- and long-term follow-up compared with control treatments. In contrast, short-term outcomes were generally comparable between PRP and control treatments. Reported adverse events were infrequent and typically mild and transient.ConclusionPRP appears to be associated with beneficial effects at intermediate and longer follow-up compared with commonly used interventions. However, the overall strength of evidence remains limited by heterogeneity in PRP protocols, comparator interventions, and outcome reporting, while incomplete and variable reporting of adverse events precludes firm conclusions regarding safety. These findings suggest that PRP may represent a adjunct treatment-option in adhesive capsulitis when longer-term outcomes are prioritized, although standardization of PRP protocols and further high-quality research are needed.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":" ","pages":"10538127261489859"},"PeriodicalIF":1.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Turkish version of the traumatic injuries distress scale: Translation, cross-cultural adaptation and validation.","authors":"Selim Mahmut Günay, Uğur Sözlü, Nevin A Güzel, Fatma Jale Irdesel","doi":"10.1177/10538127261490793","DOIUrl":"https://doi.org/10.1177/10538127261490793","url":null,"abstract":"<p><p>ObjectiveThe Traumatic Injury Distress Scale (TIDS) is a patient-reported prognostic screening tool designed to identify individuals at risk of poor recovery following acute musculoskeletal trauma. This study aimed to translate the TIDS into Turkish, perform its cross-cultural adaptation, and evaluate its validity and reliability, and enable its use for prognostic screening in Turkish-speaking clinical settings.MethodsA total of 112 individuals aged 18-80 years were assessed for eligibility, and 95 participants with a history of traumatic injuries were included in the final analysis. After translation and cultural adaptation, the Turkish version of the questionnaire was completed by the participants. Test-retest reliability was assessed using intra-class correlation (ICC), while internal consistency was evaluated with Cronbach's alpha. Convergent validity was assessed by correlating TIDS scores with the Hospital Anxiety and Depression Scale (HADS), the Short Form-12 (SF-12), and the Pain Catastrophizing Scale (PCS). Exploratory and confirmatory factor analyses (EFA and CFA) were performed to assess the construct validity of the scale.ResultsExploratory factor analysis (EFA) revealed a three-factor structure, and CFA showed excellent fit indices (χ²/df = 0.91, TLI = 0.95, CFI = 0.99, GFI = 0.96, RMSEA = 0.001), supporting the construct validity of the Turkish version of the TIDS. The ICC for test-retest reliability was 0.884, indicating excellent stability, while Cronbach's alpha for internal consistency was 0.734, indicating acceptable internal consistency. In addition, the total TIDS score showed correlations of varying strength with the HADS, SF-12, and PCS scores, supporting convergent validity.ConclusionThe Turkish version of the TIDS can be considered a reliable and clinically useful instrument for assessing posttraumatic distress in Turkish-speaking populations, while also providing valuable prognostic information to inform treatment planning and management.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":" ","pages":"10538127261490793"},"PeriodicalIF":1.6,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted gait training in stroke based on ambulatory status: A systematic review and meta-analysis.","authors":"Eun-Ji Kim, Yixin Wang, Hye-Seon Jeon","doi":"10.1177/10538127261489850","DOIUrl":"https://doi.org/10.1177/10538127261489850","url":null,"abstract":"<p><p>BackgroundRobot-Assisted Gait Training (RAGT) can improve gait and balance after stroke; however, its efficacy depends on ambulatory level, robot type, and outcome measure.ObjectiveThis meta-analysis evaluated the overall and subgroup-specific effects of RAGT in stroke patients based on ambulation level, robot type, and outcome measures to guide individualized rehabilitation strategies.MethodsSix databases (PubMed, Scopus, MEDLINE, Embase, Web of Science, and CINAHL) were searched through December 1, 2024. Twenty RCTs involving patients with stroke who underwent exoskeletal or end-effector RAGT were included. Subgroup analyses examined ambulation classification (independent or assisted ambulators), robot type (exoskeletal or end-effector), and outcome measures, including gait speed (m/s), the timed up-and-go (TUG) test, the Berg Balance Scale (BBS), and the FMA-LE.ResultsRAGT resulted in a small but statistically significant improvement in the gait and balance of patients with stroke. Small effect sizes were identified across the ambulatory levels. The exoskeletal robot group demonstrated a small effect size, whereas the end-effector group showed no significant changes. Subgroup analysis revealed RAGT was most effective in improving gait speed and TUG test performance among independent ambulators, whereas improvements in BBS scores were more prominent among those requiring assistance. The FMA-LE outcomes showed small but statistically significant improvements overall, with improvements observed primarily among assisted ambulators, not among independent ambulators.ConclusionThis meta-analysis supports the effectiveness of RAGT for improving gait and balance in patients with stroke. Findings suggest that tailoring robotic interventions should be based on ambulation classification and rehabilitation goals.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":" ","pages":"10538127261489850"},"PeriodicalIF":1.6,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pelvic incidence-lumbar lordosis mismatch in non-specific low back pain: Associations with pain, disability and lumbar structural findings - A retrospective cross-sectional study.","authors":"Ertan Yilmaz, Kubra Ustaomer, Cihan Ozgur, Birol Topcu, Banu Sarifakioglu","doi":"10.1177/10538127261490651","DOIUrl":"https://doi.org/10.1177/10538127261490651","url":null,"abstract":"<p><p>BackgroundPelvic incidence-lumbar lordosis (PI-LL) mismatch is associated with adverse outcomes in spinal deformity, but its relevance in nonspecific low back pain (LBP) is unclear.ObjectiveTo assess whether PI-LL mismatch is associated with pain, disability, symptom duration and structural findings in nonspecific LBP.MethodsIn this retrospective cross-sectional study, consecutive patients aged 30-65 years with conservatively managed nonspecific LBP ≥4 weeks and lumbar magnetic resonance imaging plus standing lateral radiography from May 2022 to May 2023 were identified from hospital records and assessed at a single standardized visit between May 2023 and February 2024. Pelvic incidence and L1-S1 lordosis were measured; mismatch was defined as ≥10°. Pain (visual analogue scale, VAS), disability (Oswestry Disability Index, ODI), facet tropism (facet angle asymmetry >7°), and Goutallier-graded paraspinal fatty infiltration were assessed. Groups were compared with parametric and non-parametric tests and multivariable linear regression; the sample could detect d = 0.55 (80% power, α = 0.05).ResultsOf 105 patients, 51 had a mismatch. VAS, symptom duration and ODI were higher in the mismatch group. After adjustment, a mismatch remained independently associated with higher VAS and longer duration, but not with ODI. Facet tropism was more prevalent at L4-5 and L5-S1, and multifidus fatty infiltration was higher at L2-3.ConclusionIn conservatively managed nonspecific LBP, PI-LL mismatch was independently associated with greater pain and longer symptom duration and co-occurred with segment-specific structural changes. Prospective studies are needed to establish its prognostic values.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":" ","pages":"10538127261490651"},"PeriodicalIF":1.6,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic utility and long-term management strategy of cervical medial branch blocks in chronic facet-mediated pain: A systematic review.","authors":"Aram Doo, Seung Park, Yeon-Dong Kim","doi":"10.1177/10538127261488130","DOIUrl":"https://doi.org/10.1177/10538127261488130","url":null,"abstract":"<p><p>BackgroundCervical medial branch blocks (CMBBs) are widely used for chronic facet-mediated pain, yet their therapeutic role, duration of benefit, and optimal repeat intervals remain unclear.ObjectiveTo systematically evaluate therapeutic effectiveness, duration of benefit, and optimal repeat intervals of CMBBs for chronic cervical facet pain.MethodsSystematic search of MEDLINE, Embase, Web of Science, and Cochrane Library through November 2025. Inclusion: randomized controlled trials and observational studies reporting therapeutic outcomes of CMBBs in adults. Independent dual review with quality assessment using RoB 2 and ROBINS-I tools. Qualitative synthesis following SWiM guidelines was performed due to substantial heterogeneity in diagnostic protocols, intervention parameters, and outcome measures.ResultsEleven studies (4 RCTs, 7 observational; N > 1200 patients) demonstrated that 55-80% of patients achieved clinically meaningful benefit (≥50% pain relief). Median duration of analgesic effect ranged from 8-16 weeks, with bupivacaine showing longer duration than lidocaine. Repeated CMBBs at 3-4 month intervals maintained therapeutic effectiveness over 12-24 months without tachyphylaxis. No major complications were reported.ConclusionsModerate-certainty evidence supports CMBBs as effective therapeutic interventions providing short- to intermediate-term relief (8-16 weeks) for chronic cervical facet pain. An evidence-based repeat interval of 3-4 months maintains effectiveness without tachyphylaxis. CMBBs represent a safe, repeatable strategy, particularly when radiofrequency neurotomy is not feasible or preferred.Clinical RelevanceThis review provides evidence-based guidance for long-term CMBB management with practical repeat interval recommendations applicable to multidisciplinary spine and pain practice.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":" ","pages":"10538127261488130"},"PeriodicalIF":1.6,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single versus triple low-molecular-weight hyaluronic acid injection strategies with shockwave therapy for rotator cuff lesions: A randomized study with an exploratory historical comparator.","authors":"Jih-Yang Ko, Chung-Cheng Huang, Po-Hua Huang, Jeng-Wei Chen, Chin-Yi Liao, Shu-Jui Kuo","doi":"10.1177/10538127261489861","DOIUrl":"https://doi.org/10.1177/10538127261489861","url":null,"abstract":"<p><p>BackgroundRotator cuff lesions without full-thickness tear commonly cause shoulder pain and functional limitation. Hyaluronic acid (HA) injections and extracorporeal shockwave therapy (ESWT) are widely used conservative treatments, but the optimal HA dosing strategy combined with ESWT remains unclear.ObjectiveTo evaluate the additional clinical benefit of ESWT combined with a single LMWHA injection and to explore whether reducing LMWHA injections from three to one is associated with differences in longer-term outcomes.MethodsIn the prospective randomized arm, participants received a single LMWHA injection with real (n = 28) or sham ESWT (n = 29). A prespecified historical cohort receiving three weekly LMWHA injections plus ESWT (n = 31) was included for exploratory comparison. CMS at 12 months was the principal efficacy outcome.ResultsAmong 57 randomized participants and 31 in the exploratory historical cohort, 1LMWHA + 1ESWT produced better 12-month CMS than 1LMWHA (88.1 ± 7.6 vs 79.0 ± 14.0; adjusted mean difference, 9.55 points; 95% CI, 4.14 to 14.97). CMS PASS was achieved by 84.6% versus 55.6% of participants (p = 0.035). The exploratory three- versus single-injection ESWT comparison showed a smaller 12-month CMS difference (adjusted, -1.63 points; 95% CI, -7.04 to 3.79). MRI progression occurred only in the 1LMWHA group (3/27 vs 0/55) and was analyzed descriptively.ConclusionA single LMWHA injection combined with ESWT improved 12-month functional outcomes compared with sham ESWT. No significant differences were detected after 6 months relative to the exploratory historical three-injection regimen, but equivalence or non-inferiority cannot be inferred.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":" ","pages":"10538127261489861"},"PeriodicalIF":1.6,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}